Liver transplantation for hepatocellular carcinoma

Rick Selby, Zakiyah Kadry, Brian Cari, Andreas Tzakis, Juan R. Madariaga, Shunzaburo Iwatsuki

Research output: Contribution to journalArticle

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Abstract

Total hepatectomy plus liver transplantation was performed on 105 patients considered unsuitable for liver resection. Postoperative 5-year actuarial survivals correlated with the pathologic stage of the tumor: stage I 75%, stage II 68%, stage III 52,1%, and stage IVA 11%. The overall 5-year survival for all patients was 36%. Nodal disease, bilobar tumor, and macroscopic venous invasion were significant poor-prognosis features. In addition, 12 patients with pT4N1M0 lesions (also stage IVA) had hepatectomy plus more extensive en bloc regional resection (Whipple procedure or cluster resection) plus transplantation in an effort to prevent local recurrence. Only 2 of these 12 patients (16.7%) are alive and free of disease after 2 years. Seven patients (58%) have died from tumor recurrence usually originating from distant metastases an average of 10.6 months after transplantation. Successful transplantation for hepatoma depends on screening programs to identify early stage disease. Successful outcome of transplantation for late stage disease, which includes most of the patients in our series, awaits the development of neoadjuvant therapy to control distant microscopic metastases, which are almost certainly present though not apparent at the time of transplantation.

Original languageEnglish (US)
Pages (from-to)53-58
Number of pages6
JournalWorld Journal of Surgery
Volume19
Issue number1
DOIs
StatePublished - Jan 1 1995

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Liver Transplantation
Hepatocellular Carcinoma
Transplantation
Hepatectomy
Neoplasm Metastasis
Recurrence
Neoplasms
Neoadjuvant Therapy
Survival
Liver

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Selby, R., Kadry, Z., Cari, B., Tzakis, A., Madariaga, J. R., & Iwatsuki, S. (1995). Liver transplantation for hepatocellular carcinoma. World Journal of Surgery, 19(1), 53-58. https://doi.org/10.1007/BF00316980
Selby, Rick ; Kadry, Zakiyah ; Cari, Brian ; Tzakis, Andreas ; Madariaga, Juan R. ; Iwatsuki, Shunzaburo. / Liver transplantation for hepatocellular carcinoma. In: World Journal of Surgery. 1995 ; Vol. 19, No. 1. pp. 53-58.
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Selby, R, Kadry, Z, Cari, B, Tzakis, A, Madariaga, JR & Iwatsuki, S 1995, 'Liver transplantation for hepatocellular carcinoma', World Journal of Surgery, vol. 19, no. 1, pp. 53-58. https://doi.org/10.1007/BF00316980

Liver transplantation for hepatocellular carcinoma. / Selby, Rick; Kadry, Zakiyah; Cari, Brian; Tzakis, Andreas; Madariaga, Juan R.; Iwatsuki, Shunzaburo.

In: World Journal of Surgery, Vol. 19, No. 1, 01.01.1995, p. 53-58.

Research output: Contribution to journalArticle

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Selby R, Kadry Z, Cari B, Tzakis A, Madariaga JR, Iwatsuki S. Liver transplantation for hepatocellular carcinoma. World Journal of Surgery. 1995 Jan 1;19(1):53-58. https://doi.org/10.1007/BF00316980